One-year outcomes of spinopelvic fixation in unstable pelvic trauma patients: A prospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Spinopelvic injuries represent some of the most complex challenges in orthopedic trauma, with profound implications for patient function and quality of life. This study aimed to evaluate the comprehensive one-year clinical, functional, and radiographic outcomes of spinopelvic fixation in a cohort of patients with unstable pelvic trauma. A prospective cohort study was conducted at two university-affiliated trauma centers. Between March 2023 and March 2024, 54 consecutive adult patients with traumatic spinopelvic instability who underwent surgical fixation were enrolled, with 45 completing the one-year follow-up (follow-up rate: 83.3%).Primary outcomes included the Majeed Pelvic Score (MPS). Secondary outcomes encompassed pain severity (Visual Analogue Scale, VAS), functional independence (SF-36 Physical Functioning subscale, Barthel Index), radiographic parameters (vertical pelvic displacement, leg length discrepancy), and surgery-related complications. Assessments were performed preoperatively and at 2 weeks, 1, 3, 6, and 12 months postoperatively. The mean patient age was 41.9 ± 13.5 years, with 73.3% male. The most common injury patterns were AO/OTA 61-C type injuries (62.2%) and Denis Zone II sacral fractures (48.9%). A significant and sustained improvement was observed in the MPS, increasing from 35.0 ± 8.2 at two weeks to 84.0 ± 7.1 at one year (p<0.001). Pain scores demonstrated a significant reduction over time (p<0.001). However, at the 12-month follow-up, chronic pain (defined as VAS >4 for ≥2 consecutive months after postoperative month 3) was present in 35.6% (n=16) of patients. Functional scores (SF-36 PF, Barthel Index) showed marked improvement (p<0.001). Radiographically, mean vertical pelvic displacement decreased from 14.2 ± 4.1 mm preoperatively to 3.8 ± 1.9 mm postoperatively (mean difference 10.4 mm; 95% CI 9.2–11.6, p<0.001), and leg length discrepancy was significantly reduced from 31.0 ± 12.0 mm to 9.0 ± 1.0 mm (p<0.001). The overall complication rate was 20%, including surgical site infection (8.9%), implant failure (4.4%), and neurologic injury (4.4%). In carefully selected trauma patients with unstable pelvic injuries, spinopelvic fixation facilitates significant improvement in pelvic function, pain reduction, functional independence, and anatomical restoration at one-year follow-up. While the complication rate is notable, most complications were manageable. The high prevalence of chronic pain at one year highlights an area requiring targeted multidisciplinary intervention. Therapeutic Level IV.
Source: Journal of Orthopaedic Reports
Institution: Tabriz University of Medical Sciences
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $600
OpenAlex ID: W7153828071